When to Say Yes or No,

How to Achieve Local and National Visibility

AAS Early Career Development Course

Jeffrey B. Matthews, MD FACS

Dallas B. Phemister Professor and Chairman

Surgeon-in-Chief, The University of Chicago

A 32 year old Assistant Professor of Surgery is in the

second year of a 3 year research start-up package,

while also attempting to grow a clinical practice in

general surgery (50% commitment).

The dean’s office calls regarding a vacancy on the IRB

that needs a physician-scientist. There are no other

surgeons on the committee.

2 Saying No

Yes or no?

• Career advancement including academic promotion requires focused

scholarship and the creation of an original body of work

• Advancement also involves progressive participation in regional and national

activities

– Society committees, invited lectures, study section, manuscript reviews, chapter

writing, editorial board position

• Local institutional “citizenship” is also valued

– Committees, lectures, attendance at department meetings, events, local society

work

• Tension between self-interests and altruism – some requests are distractions,

some lay track for future advancement, some are citizenship/obligations

Framing the problem

3 Saying No

Should the Assistant Professor join the IRB?

• Yes

– Surgeon presence on IRB is

important

– Responsibility to do work on

behalf of department

– Resonant with surgeon-

scientist phenotype, good

learning opportunity

– Highly meaningful activity

– Visible and valuable leadership

role with institutional impact

• No

– Distraction from start-up

efforts in critical phase of

research development

– Clinical obligations

– Major time commitment

irrespective of whether

compensated

– Relatively junior and

inexperienced to adequately

serve duties

– No external impact

4 Saying No

• Might be appropriate for more senior faculty with established labs, or formerly

funded

• Timing is wrong

• Chair should protect

Yes or no to the IRB?

5 Saying No

What if it was the transfusion committee?

6 Saying No

• Everybody must do something on behalf of the larger enterprise, but early

academic careers should be protected from these, especially high-intensity

time commitments (IRB, promotions committee, admissions committee)

• Ideally will be consistent with faculty member’s career track (clinician,

clinician-educator, etc)

Hospital/department committee work

7 Saying No

• Academic and leadership advancement involves learning to multitask

and to deliver on-time and high quality work

– “If you want something done, ask a busy person”

• Need an understanding of what is required for each new assignment :

frequency of meetings, between-meeting work assignments

• Piling on of multiple small, simple but worthwhile activities can accrete

into an unmanageable situation distracting from main responsibilities

• Comp plans can unintentionally misalign incentives or create

unrealistic expectations of $ or effort support that are part of overall

job description

Time/effort and compensation considerations

8 Saying No

Most of these yes/no decisions should not revolve

around the question of compensation for the activity.

If they do, it may indicate a mission/vision/values mismatch…

9 Saying No

• Some argue this is a waste of time: it is uncompensated, you get no

“credit”, and it’s essentially invisible work that distracts you from other

responsibilities

• I disagree. In general, you should be biased to say yes

• Heart and soul of an academic career is participation in peer review

– You expect your own work to be expertly evaluated; to not offer the same

for other investigators is the height of hypocrisy

– It’s a duty and an honor. Do it well.

– Good reviewers get rewarded: elevation to editorial board, other

opportunities (program committees, invited reviews, etc.)

Manuscript reviews

10 Saying No

• No more than ~3 reviews a month in aggregate, or more than 1-2 for a single

journal unless you have higher level of responsibility (editorial board

membership, leadership role in organization)

• Do not expect to be put on the ed board after only a handful of reviews

• You should not review outside area of expertise, but don’t draw too narrowly

• If you say no, state a reason and if possible suggest a colleague as alternate

• Prioritize the highest impact journals or the ones that are most relevant for

your career interests – you do not need to review for every journal in your field

• If you’ve never heard of the journal, say no.

• Never accept honorary editorial board positions from sketchy publishers

Manuscript reviews: caveats

11 Saying No

Time management

• Increasing demands on your time

requires learning efficiency

• You need to complete tasks in timely

fashion and also do them well

– Respect deadlines

• Reputations are built on reliability

• Strategies to carve out time for these

additional roles

– Early morning

– Multitasking at home

12 Saying No

• Essential to developing reputation, necessary for academic advancement

• How many societies?

– Combination of generalist and subspecialty societies

– Limit to highest impact, most relevant

• Which committees?

– Relevant to career; some types are very important (program committee)

– Importance of attendance, doing more than what is asked

– Most organizations are meritocracies

• Invited speaker/panelist

• Visiting professorships

National/international activities: yes or no?

13 Saying No

• Is it incremental work, or can I stop doing something else?

• What is the time commitment and work expectation?

• Is it coherent and aligned with my career plan or academic track?

• Does this activity apply toward promotion criteria?

• Does it build a “balanced portfolio” of activities?

• Is it part of my “duty” as a department member or academic citizen?

• Is it visible, and to the appropriate audience?

• Is there “credit” for my role? Does it increase my credibility?

• Does the activity, done well, lead to more opportunities?

Questions to ask yourself

14 Saying No

15 Saying No

If you say no too often, or inappropriately, the requests will stop…

“There is only one thing worse than being talked about

and that is not being talked about.”

Oscar Wilde The Picture of Dorian Gray (1891)

• Comes from saying YES

• Comes from creating SUBSTANCE

• Comes from growing REPUTATION for reliability

• Comes from creating a NETWORK

Local and national visibility

16 Saying No

Scientific meetings at a crossroads?

You schmooze, you lose?

18 Saying No

• Achieving visibility requires the growth of your own portfolio of original

scholarship and expertise – without this, the discussion is irrelevant

• Committee work, journal reviews, and other time-consuming activities are also

essential nuts and bolts in building a successful career.

• In early career, it can be hard to know which opportunities to accept. Use

mentors as needed to sort out the relevant plusses and minuses.

• There are some roles that may not be glamorous or highly rewarding that are

simply part of the duties of being an academic surgeon – everybody must do

something

• Try to say yes to as many legitimate opportunities as you can

• As career advances, look for roles to shed to make space for new ones

Nuts and Bolts of an Academic Career

19 Saying No